Individual provider Active NPI

Geraldine Jody Stubler, APRN

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1861892861
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
223189-4405 Issued in UT
Practice address
1345 E 3900 S
Suite 204
Salt Lake City, UT 84124-1474
Phone
(385) 275-4673
Fax
(801) 999-4166
NPI assigned
Aug 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 223189-4405 UT Primary

Addresses

Primary practice location

1345 E 3900 S
Suite 204
Salt Lake City, UT 84124-1474

Mailing address

1345 E 3900 S
Suite 204
Salt Lake City, UT 84124-1474
Phone (385) 275-4673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170202001199 UT Practitioner - Nurse Practitioner 5294018099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

166 E 5900
Suite B109
Salt Lake City, UT 84107-7293
Phone (385) 275-4673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Family Medical Center LLC Family CurrentSince Mar 16, 2015 Accepting new patients
Anywhere Care Family Current Accepting new patients

Locations

166 E 5900 S
Salt Lake City, UT 84107
Phone (801) 266-1412

166 E 5900 S
Ste B109
Salt Lake Cty, UT 84107
Phone (385) 275-4673

1345 E 3900 S
Ste 204
Slc, UT 84124
Phone (385) 275-4673

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1861892861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 E 3900 S",
            "address_2": "SUITE 204",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241474",
            "telephone_number": "385-275-4673",
            "fax_number": "801-999-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 E 3900 S",
            "address_2": "SUITE 204",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241474",
            "telephone_number": "385-275-4673",
            "fax_number": "801-999-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBLER",
        "first_name": "GERALDINE",
        "middle_name": "JODY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "223189-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.